A long-awaited agreement between physicians, nurses and state legislators to increase the prescriptive power of advanced practice nurses could improve Texans’ access to care, health care leaders said Wednesday.

“Physicians, nurse practitioners, and physician assistants are natural partners in the delivery of appropriate and compassionate patient care," Dr. Michael Speer, president of the Texas Medical Association — the state's largest physician organization — said in a statement.

The legislation, filed by Rep. Lois Kolkhorst, R-Brenham, chairwoman of the House Public Health Committee, and Sen. Jane Nelson, R-Flower Mound, chairwoman of the Senate Health and Human Services Committee, will eliminate on-site physician ...

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This is the current diagram to demonstrate how prescriptive authority is authorized. Makes you a little dizzy, huh? Dangerous drugs means all prescription medications, not just scheduled medications. These changes are badly needed as it is very hard to find primary care providers accepting new medicaid patients leading many folks to use the emergency room as their only access to care. http://www.cnaptexas.org/associations/9823/files/Handout_Diagram_%20Delegated_Rx_Authority.pdf

Movements to allow access of Texans to benefit from healing provided from nurse practitioners and physician assistants is sound public policy.

The lion's share of office visits are for fairly routine complaints and there is no justification for having a log jam of patients due to banning nurse practitioner and physicians assistants from prescribing medications or diagnosing and treating routine complaints.

I would not want to have surgery for a neuroblastoma performed by an NP, but I am more than willing to have a shallow dog bit treated by one.

This brings up a dire situation that we have in Texas. The only way that some of our hospitals are able to keep their doors open is that they have recruiters scouring the developing countries of the world, stealing scarce RN and physician resources to serve as RNs in Texas, to the wrath of both the World Health Organization and the Gates Foundation. These developing countries have dire shortages of health professionals, and if our hospitals abscond with them to staff Texas hospitals, incredible suffering results,

Texas should set a goal of becoming completely organically self-sufficient in its generation of RNs by the pivotal year of 2020, eliminating this theft of scarce medical professionals from developing countries,

We are facing a "perfect storm" crisis in RN resources in Texas, facing dire shortages due to four factors:

a ) Texas has inadequate capacity in nursing schools,b ) there is a tendency for RNs to retire at age 55, as this is hard physical workc ) the pig going through the python demographic surge of baby boomers hitting the age at which more medical procedures are require will massively increase the demand for RNs to treat boomers.d ) virtually all forecasts predict a profound and sustained shifting of population from elsewhere into Texase ) California has already implemented a rule limiting to 5:1 the ratio of patients to nurses to patients, It is only time before this practices spreads to Texas and the rest of the nation.

We are in dire need of better quality and more nursing schools.

Texas has one shining star in nursing education. Last year the accrediting authority for nursing schools recognized THE FIRST and THE ONLY Texas school to qualify as one of nineteen "Circles of Light in Nursing Education" among the two thousand nursing schools nationally.

This outstanding nursing school, whose seniors score at the very top in the professional Registered Nurse qualification examination is that of Collin College at it McKinney campus.

Each graduate gets to chose among several eager bidders for their services as employees.

February 7, 2013 @ 12:45 p.m.

Healthy Texan

The pill mill problem relates to Schedule III drugs. Go back and listen to the TMB general counsel's testimony at the May 15, 2012 House Public Health Committee hearing in Houston. She states clearly that its Schedule III drugs that are the problem. And besides, one would assume that with all that "supervision" being provided by physicians that APRNs wouldn't be the pill mill problem.

The real issue is why Texas statutes continue to limit the legal abilities of APRNs. Texas, along with Florida and Mississippi are the 3 most tightly regulated states that prohibit the effective use of APRNs. All this does is limits the ability of APRNs to be effectively utilized into the primary care system. And, it allows physicians to make money while patients suffer from lack of access and higher costs. Taxpayers also suffer because more patients are headed to the ER for uncompensated care.

The system in Texas is ridiculous and any arguments to keep the status quo are ridiculous.

February 10, 2013 @ 9:55 a.m.

Kathy Ross

Make no mistake, this is a huge win for MEDICINE. Nurse practitioners still can't prescribe medications without delegated authority from a physician. For those nurse practitioners who own clinics, they'll still continue to pay an extortion fee, since no physician is going to do this for free.

I've never seen a physician adhere to the site restrictions, so this just makes everything they've been doing legal now. Now they can "supervise" up to SEVEN nurse practitioners without ever being on site. I know some physicians who have "supervised" as many as TEN nurse practitioners/physician assistants and those were at alternate and primary sites, not medically underserved sites. They've done this for years without ever reviewing one chart and without ever getting caught. This practice has made several of them millionaires. If you think it's even possible for one physician to supervise that many full time nurse practitioners, then you're obviously not in the medical field.

If you want to end the monopoly of medicine and increase competition, then eliminate prescriptive authority. Studies have already proven that doesn't decrease the quality of care. This is nothing more than a turf battle and everyone knows it. The Texas Medical Association will go down fighting and trying to protect every penny they can for their members, without a care or thought for the millions of people in need of health care services.